Bard: Pelvic Organ Prolapse

An overview of Pelvic OrganProlapse

Bard: Prostate Cancer Treatment

Prostate CancerTreatmentInformation andAnswers

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A Brief Overview

Prostate

Bladder

Urethra

Prostate Anatomy

The prostate gland, approximately the size of a large

walnut, is located behind the base of the penis, above

the rectum and below the bladder. Its purpose is to

secrete components of semen.

Although prostate cancer is the second leading cause

of death in men, if caught in the early stages, the 5-year

survival rate is extremely good. As a result, significant

research has been done into new and more innovative

ways to diagnose and treat this disease.

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Stage T1 is prostate cancer

in its earliest stage. Cancer

is confined to the prostate

gland and the patient rarely

experiences any symptoms

of disease.

Prostate cancer tumors are staged to determine how far

the cancer has spread.

A Stage T3 tumor has

spread outside the gland to

surrounding tissues, such as

the seminal vesicles.

At Stage T2, cancer is still

localized in the prostate

gland and is usually in the

form of a small to large, hard

nodule.

Stage T4 prostate cancer

has spread outside the

gland to other tissues and

perhaps other organs, such

as the bladder or the lungs,

liver or bone.

Prostate Cancer Staging

The stage of a cancer is the most important factor in

choosing treatment options an predicting a patient’s

outlook for survival.1

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PSA Testing

Gleason Scores

A PSA (Prostate Specific Antigen) test is considered by

many physicians to be an important diagnostic tool for

detecting the presence of prostate cancer.

When prostate cancer develops, the PSA level usually

goes above 4. But it is important to remember that

about 15% of men with a PSA below 4 will have prostate

cancer on biopsy. If your level is in the borderline range

between 4 and 10, you have about a 25% chance of

having prostate cancer. If it is more than 10, your chance

of having prostate cancer is over 50% and increases

more as your PSA level increases.1

If your PSA level is high, your doctor may recommend a

prostate biopsy to find out if you have cancer.1

The Gleason test is a grading scale that helps the

physician determine how likely a patient’s cancer may

spread. Tissue removed from the prostate during

biopsy is examined microscopically and graded. The

higher your Gleason score, the more likely it is that your

cancer will grow and spread.

Digital Rectal Exam (DRE)

During a DRE, the physician inserts a gloved, lubricated

finger into the rectum and examines the prostate for

any irregularities in size, shape, and texture. Often,

the DRE can be used by urologists to help distinguish

between prostate cancer and non-cancerous conditions

such as BPH.

American Cancer Society recommends that when

prostate cancer screening is done, both the DRE and

PSA blood test should be used.1

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Current Treatment Options

Brachytherapy

Also known as “interstitial radiation,” brachytherapy is

the permanent implanting of radioactive “seeds” into

the prostate gland. Brachytherapy delivers a prescribed

dose of radiation directly to the cancer cells. There is

only limited radiation to surrounding tissues such as the

urethra and rectum. The seeds are usually permanently

implanted and the radiation dissipates over time.

Brachytherapy may be used alone or in combination

with external beam radiation and/or hormonal therapy.

Generally, it is an outpatient procedure. Some patients

experience inablility to maintain an erection (impotence),

loss of bladder control (incontinence), and narrowing of

the urethra (urethral strictures).

Surgery

Radical prostatectomy is the surgical removal of the

prostate gland and it typically involves a hospital stay

of several days. The two most common side effects of

this surgery are loss of bladder control (incontinence)

and the inability to maintain an erection (impotence).

External Radiation

This treatment involves the use of high-energy X-rays

directed from outside the body at the prostate gland,

and normally requires treatment 5 days per week for

6 to 8 weeks. Side effects may include problems with

urination and impotence, as well as injury to the bowel.

Hormone Therapy

Hormones are adminstered to lower the levels of

testosterone (male hormone) which slows the growth

of cancerous cells over a period of time. Under certain

circumstances, hormones may be used in combination

with brachytherapy to shrink the prostate and the

tumor.

Watchful Waiting

Since many prostate cancers are slow-growing, a

physician may recommend close observation for a

period of time without any active treatment, during

which the tumor’s progress is carefully monitored.

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Pre-Implant

Before you undergo the seed implant procedure, your

physician may schedule a series of pre-op tests, such

as blood tests and a chest X-ray.

In addition, you will be given an

ultrasound test designed to measure

the size, shape and location of your

prostate. This test provides a “map”

which helps determine how many

seeds will be needed (usually between 60 and 120).

Brachytherapy is typically done on an outpatient basis.

The length of the average procedure is about one to

one-and-a-half hours. Just before the seed implantation,

another ultrasound image is taken of your prostate to

complete the planning process and

to ensure that the seeds will be

placed where they are needed.

You will probably receive general or

spinal anesthesia to ensure that you

will have no discomfort during the

procedure.

During the procedure, an ultrasound probe is positioned

inside the rectum to make the prostate visible on a

monitor and permit the team of doctors to view the

placement of each seed. Needles are inserted through

the skin between the scrotum and rectum, and the seeds

are placed into the prostate.

Procedure Overview

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After the procedure, you will be taken to the recovery

room until the effects of the anesthesia have worn off.

Before you leave the hospital, you will receive specific

instructions and precautions and, in some cases, your

doctor may prescribe an antibiotic. Your physician may

advise that you avoid strenuous types of activity for

the first few days after the procedure, but you should

be able to resume your normal routine within a matter

of days.

Post Implant

Once all seeds have been implanted, your doctors will verify on the X-ray monitor that the seeds have been placed accurately.

X-ray image of seed placement

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Prostate Cancer Facts

The American Cancer Society estimates that during

2010 about 217,730 new cases will be diagnosed

in the US.1

1 in 6 men will be diagnosed during his lifetime, but

only 1 in 34 will die of it.1

The death rate for prostate cancer is going down, and the disease is being found earlier as

well.1

If detected early, prostate cancer

is often treatable.

African American men have the highest rate of

prostate cancer in the world. In fact, the incidence

rate for African American men is 60% higher than in

white males.1

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“The Prostate Cancer Treatment Book”, Peter D. Grimm, D.O.; John C. Blasko, M.D.; and John E. Sylvester, M.D. ISBN: 0-07-142256-0

“American Cancer Society’s Complete Guide to

Prostate Cancer”, David G. Bostwick, MD, MBA; E.

David Crawford, MD; Celestia S. Higano, MD; Mack

Roach III, MD

ISBN: 0-944235-54-9

“Seeds of Hope”, Michael A. Dorso, M.D.

ISBN: 0-9774449-1-0

“Surviving Prostate Cancer Without Surgery”,

Michael J. Dattoli, M.D.; Jennifer Cash, ARNP, MS,

OCN; Don Kaltenbach, Prostate Cancer Survivor

ISBN: 0964008882

American Cancer Society

www.cancer.org/cancer/prostatecancer/index

Information Resources

Consult the following resources to learn more about

prostate cancer and what is being done to diagnose

and treat the disease more effectively:

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US TOO International, Inc.

5003 Fairview Avenue

Downers Grove, IL 60515-5286

Telephone: 630/795-1002; Fax: 630/795-1602

Toll-Free Hotline: 800/80-US-TOO (800-808-7866)

Man-To-Man

Contact your local American Cancer Society Office

or call 1-800-ACS-2345 for more information about

this program.

The American Cancer Society www.cancer.org

National Cancer Institute www.nci.nih.gov

University of Pennsylvania www.oncolink.upenn.edu

Bard Medical www.bardmedical.com

Support Groups

Web Sites

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C. R. Bard, Inc., Covington, GA 30014 - 800.526.4455

Bard is a registered trademark of C. R. Bard, Inc.

Please consult product inserts and labels for any indications, contraindications, hazards, warnings, cautions, and instructions for use. © 2010, C. R. Bard, Inc. All Rights Reserved. Printed in the U.S.A.

1010-23 R11/10 THP P11/10 10M

1American Cancer Society. Cancer Facts and Figures 2007. Atlanta, GA: American Cancer Society; 2007 Available at: www. cancer.org

Be sure to discuss all questions thoroughly with

your physician. Becoming more knowledgeable

about prostate cancer is an important step in your

treatment and recovery.

Your physician supplied this information to help

you learn about and choose treatment options.

Each option has potential side effects. Your choice

should be made after considering your condition,

circumstances and goals. Please consult your

physician with any questions or concerns. You may

want to review these options with a spouse or family

member.